#: 781609 S2/News and Newcomers [DIABETES] 22-Jan-98 11:11:07 Sb: #New Classifications DM Fm: SYSOP-Angela Chiffy 73513,2026 To: All In July, 1997, the ADA released a report which outlined a new classification scheme for diabetes in the journal, DIABETES CARE ("Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus", DIABETES CARE, 1997;20:1183-1197). The purpose of having a new classification scheme is to move away from a system which classifies people based on treatment type and to move to one based primarily on the cause of the diabetes. They state that while most people will still fall into type 1 and type 2 categories, others will not. Also, ANY form of diabetes may require insulin treatment at some time, but using insulin in and of itself does NOT determine classification. The scheme is as follows: 1. Type 1 diabetes (_-cell destruction, usually leading to absolute insulin deficiency) A. Immune mediated B. Idiopathic 2. Type 2 diabetes (may range from predominantly insulin resistance with relative insulin deficiency to a predominantly secretory defect with insulin resistance) 3. Other specific types A. Genetic defects of _-cell function 1. Chromosome 12, HNF-1alpha (formerly MODY3) 2. Chromosome 7, glucokinase (formerly MODY2) 3. Chromosome 20, HNF-4alpha (formerly MODY1) 4. Mitochondrial DNA 5. Others B. Genetic defects in insulin action 1. Type A insulin resistance 2. Leprechaunism 3. Rabson-Medenhall syndrome 4. Lipoatrophic diabetes 5. Others C. Diseases of the exocrine pancreas 1. Pancreatitis 2. Trauma/pancreatectomy 3. Neoplasia 4. Cystic fibrosis 5. Hemochromatosis 6. Fibrocalculous pancreatopathy 7. Others D. Endocrinopathies 1. Acromegaly 2. Cushing's syndrome 3. Glucagonoma 4. Pheochromocytoma 5. Hyperthyroidism 6. Somatostatinoma 7. Aldossteronoma 8. Others E. Drug- or chemical-induced 1. Vacor 2. Pentamidine 3. Nicotinic acid 4. Glucocorticoids 5. Thyroid hormone 6. Diazoxide 7. _-adrenergic agnostics 8. Thiazides 9. Dilantin 10. Alpha-Interferon 11. Others F. Infections 1. Congential rubella 2. Cytomegalovirus 3. Others G. Uncommon forms of immune-mediated diabetes 1. "Stiff-man" syndrome 2. Anti-inulin receptor antibodies 3. Others H. Other sometimes diabetes-associated genetic syndromes 1. Down syndrome 2. Klinefelter's syndrome 3. Turner's syndrome 4. Wolfram's syndrome 5. Friedreich's ataxia 6. Huntington's chorea 7. Lawrence Moon Beidel syndrome 8. Myotonic dystrophy 9. Porphyria 10. Prader Willi syndrome 11. Others 4. Gestational diabetes mellitus #: 781641 S2/News and Newcomers [DIABETES] 22-Jan-98 15:42:14 Sb: #781609-#New Classifications DM Fm: WIZOP-Dave Groves 76703,4223 To: SYSOP-Angela Chiffy 73513,2026 (X) Gee and I used to sum it up with "26 or more" . Now will anyone tell me about "A" cure? #: 782489 S2/News and Newcomers [DIABETES] 27-Jan-98 02:25:03 Sb: #781641-#New Classifications DM Fm: SYSOP-Angela Chiffy 73513,2026 To: WIZOP-Dave Groves 76703,4223 (X) You're absolutely right: There is no such thing as a single cure for all of the different forms of dm. I think it's better we know all the varieties of dm than to try to lump all cases of dm into one or two categories, though. If we can trace the cause of the problem, then perhaps we have a better chance at correcting the problem. #: 782509 S2/News and Newcomers [DIABETES] 27-Jan-98 03:22:11 Sb: #782489-#New Classifications DM Fm: WIZOP-Dave Groves 76703,4223 To: SYSOP-Angela Chiffy 73513,2026 (X) Yup, I've only been singing that song AGAINST the cacophony of ADA for about 5 years now. #: 783186 S2/News and Newcomers [DIABETES] 30-Jan-98 18:47:13 Sb: #782509-#New Classifications DM Fm: SYSOP-Angela Chiffy 73513,2026 To: WIZOP-Dave Groves 76703,4223 (X) Hopefully, others will read the list and catch on to the fact that treatment with insulin does NOT equate with insulin dependence. #: 783267 S2/News and Newcomers [DIABETES] 31-Jan-98 00:52:14 Sb: #783186-#New Classifications DM Fm: WIZOP-Dave Groves 76703,4223 To: SYSOP-Angela Chiffy 73513,2026 (X) We can keep trying to get the world to understand. #: 784319 S2/News and Newcomers [DIABETES] 06-Feb-98 20:22:08 Sb: #783267-#New Classifications DM Fm: SYSOP-Angela Chiffy 73513,2026 To: WIZOP-Dave Groves 76703,4223 (X) Which is why we have to keep repeating the same messages over and over again. We CAN do it!! #: 784398 S2/News and Newcomers [DIABETES] 07-Feb-98 03:28:08 Sb: #784319-#New Classifications DM Fm: WIZOP-Dave Groves 76703,4223 To: SYSOP-Angela Chiffy 73513,2026 (X) I am giving serious consideration to simply "boiler-plating" most of them. #: 785213 S2/News and Newcomers [DIABETES] 12-Feb-98 01:11:08 Sb: #784398-New Classifications DM Fm: SYSOP-Angela Chiffy 73513,2026 To: WIZOP-Dave Groves 76703,4223 (X) Go for it, though I find I do try to "personalize" even my boiler-plate replies. #: 782187 S2/News and Newcomers [DIABETES] 25-Jan-98 16:50:11 Sb: #781609-#New Classifications DM Fm: Bruce MacDougall 71545,1520 To: SYSOP-Angela Chiffy 73513,2026 (X) Angela, An impressive list! Thanks for the message. Bruce #: 783187 S2/News and Newcomers [DIABETES] 30-Jan-98 18:47:13 Sb: #782187-New Classifications DM Fm: SYSOP-Angela Chiffy 73513,2026 To: Bruce MacDougall 71545,1520 (X) You're most welcome. #: 783084 S2/News and Newcomers [DIABETES] 30-Jan-98 05:39:13 Sb: #781609-#New Classifications DM Fm: Robert Walker 76615,214 To: SYSOP-Angela Chiffy 73513,2026 (X) Thanks, Angela. I finally have the list I had been looking for off and on for years. I gather you post will become a library file? #: 784320 S2/News and Newcomers [DIABETES] 06-Feb-98 20:22:08 Sb: #783084-New Classifications DM Fm: SYSOP-Angela Chiffy 73513,2026 To: Robert Walker 76615,214 (X) Robert, this list JUST came out this year. Up until this came out, the ONLY classification of dm was between type 1, type 2, GDM (gestational) and so-called "secondary" causes (e.g., chemotherapy or total removal of the pancreas). As scientists begin to understand more about dm and as they begin to recognize that treatment does not equal type (or cause), hopefully, doctors and others will begin to recognize that one person's dm is not another's dm. Of course I will put it in the library.